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REGISTRATION-CUM-APPLICATION FORM

                 
REGISTRATION-CUM-APPLICATION FORM
Name
(in block letters):
Gender: Male   Female
Date Of Birth Age:
Day Month Year
Father's/Guardian's/Husband's Name:
(With Occupation & Designation):       
Permanent Address :                           
Mobile:   Telephone:  
Address for Correspondence:               
Mobile:   Telephone:  
Community:      GEN   SC   ST   OBC 
Educational Qualification: 1. 
(Graduation and above): 2. 
3. 
Current Assignment:
No. of previous attempts and result :
UPSC/PCS/HAS/HAS Roll No.(current): 
Membership applied for: 1. Session: Prelims/Mains/Interview
  2. Course: Regular/Postal
  3. Subject (s)
I hereby declare that the information given above is true to the best of my knowledge and belief. I understand that concealment of any information as desired above, may result in termination of my membership from the institute. I further understand that the fee once paid shall not be refundable under any circumstances.
Place:  
Place:  
 I Agree to all Terms and Conditions